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HomeMy WebLinkAbout1627 CORSICA PL - Building Permits • • • CITY OF COSTA MESA :1,,,,0�114..7•, BUILDING DIVISION oa+�',"! ,. 77 FAIR DRIVE.COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714)754-5626 • PERMIT NUMBER: B11-00190 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 13919204 DATE ISSUED: 06/2012011 ISSUED BY: RMD JOB ADDRESS: 1627 CORSICA PL CM Suite/Unit: Vicinity: HOUSE AND GARAGE ROOF Squares: 2600 Valuation: $9,500.00 SCOPE OF WORK: TEAR OFF EXISTING ROOF MATERIALS, INSTALL 1 LAYER OF 30#FELT ON A 4;12 OR GREATER PITCHED ROOF, REROOF WITH 30 YEAR COMP SHINGLES ON AN ATTACHED HOUSE AND GARAGE,APPROX 26 SUQARES. REPAIR AND REPLACE SHEAHTING AS NEEDED.COMPLIANCE FORMS ATTACHED TO JOB CARD AND CITY PERMIT. NOTE:RESIDENTIAL RE-ROOF: Final approval of permit shall not be granted until access to dwelling unit(s)is provided for verification of the installation of smoke and carbon monoxide alarms by the City Inspector. See Attachment w/Inspection Card OWNER: LOPEZ-RODRIGUEZ,AMERICO Address: 1627 CORSICA PL Unit: PHONE: 206-852-2707 City/State/Zip: COSTA MESA,CA APPLICANT: GUTIERREZ, MARIO Address: Unit: : PHONE: 951-264-0008 City/State/Zip: CONTRACTOR: SUDDUTH CONSTRUCTION INC License No. 847279 Address: OSA GUARDIAN ROOFSUnit: SANTA ANA,CA PHONE: 714-423-1623 City/State/Zip: 1651 E 4TH ST 92701 CELL: ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $181.25 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 • TOTAL FEES $182.25 HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010 -PER CMMC Sec. 13-279 Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibitied all hours-Sundays and the following Federal holidays New Years Day,Memorial Day, Independence Day, Labor Day,Thanksgiving Day and Christmas Day NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE O. INSPECTION TYPE DATE INTIIIALS CODES INSPECTION TYPE DATE, INnllALE 1816 Fixed System Final Fire Prevention 206 Final Mechanical 1288 Pool Spa Final 1 (� • 208 Final Plumbing )( /J 200 Final Re-Roof LO"Z -I I r ea 1240 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy • 1 WORKERS'COMPENSATION DECLARATION: Owner ID verified by drivense. 0 Yes ❑ No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. - Expires: O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. O I have and will maintain workers'compensation insurance,as required by DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: - person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition Carrier: - a . a or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2.Gm This secaon need not be co ad the permit is va ed al one hundred dollars(5100)wlessJ 2,Art 2Sec.341,Title B,California Administrative Code), Policy Number: _ f — ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers'compensation provisions of Section 3700 of Applicant's Signature Date the Labor Code,I shall forthwith comply with these provisions. 679-70^/ Division of Industrial Safety Permit Number: Applicants Signature_ ems HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes ❑ No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license eiis(in full force and effect. /' a registration form for acutely hazardous materials? 0 Yes 0 No Licr#`-V `fl 2- -7 Classf# --. f 3"/',1 (Section 25533 of the California Health and Safety Code, with some r)/ ''") exceptions, requires registration with the Costa Mesa Fire Department by ale/ (o — Lo-- l// each business which at any one time has on hand a quantity of acutely Contractor'sSignature Date) hazardous materials equal to or greater than a weight of 500 pounds. or a volume of 55 gallons. or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 9 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Dale 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for ran-residential building permits). License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Ouality Management District or other compensation. WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by Califomia License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No thereon,and who does such work himself or herself or through his or her own 8. (If yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and IDI, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044,Business and _ Professions Code: The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.), certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Su . •1 Legal Owner(s) Date Signature Date --2‘57 ate2 3057.46 13107) — �/5 Age/or. ��^17.�'... ..nt Date Prescriptive Certificate of Comm.—ice: 12esidenti d - t CF-112-ALT Residential Alterations (Page 1 of 5) Project Name: �Z Climate lone ti J I I)of Stories General Information Site Address: heel Ca 0,,, N_ uA , Enforcement Agencyee- /40wl Date: y(�1 1( Building Typengle Family 0 ulti Family-•' Circle the Front Orientation:N,E,S, W,or degrees � 1/�� Conditioned Flow Area(Ci: " / ��/ 1✓ Project Type: ❑Alterations 0 Envelope❑Fenestration.kd'itoof 0 HVAC (S, ! Replacement or Change Out ❑Duct Replacement ❑ Water Heater NOTE: This form is not to be used far Newly Constructed Buildings or Additions • Insulation Values For Opaque Surfaces'(for Furring use the Mass and Furring Strips Construction table below) Assembly Alteration ❑Opening of framed cavity alone-Alterations that involve the opening of thefrramed cavil'of a wall,ceiling, or floor must install the mandatory minimum insulation value per§1511for the altered assembly.Fill in Columns A-C and enter mandatory insulation value in Column IL ❑ Replacement of entire assembly-Replacement of an entire wall, ceiling,or floor assembly requires the installation of Component Package-D insulation values in Table 151-C. Fill in Columns A-J. . Opaque Surface Details For the furred portioned of Mass Walls see Furring Strips Construction Table below. A It C I I) C ' _ ' F C H • .1. • 1. d Proposed sK na,c Standard Values From 1A4 Table Framing Thickness, Framed Continuous ]A4 Proposed Tag/ Assembly Name Material Spacing, U- 1A4 Table Cavity Insulation Assembly Assembly IDI or Type' and Size2 or Other' factor' _ Number5 R-valuee R-Value' Cell Values U-factory Note:Par furred assemblies,accounting for Continuous Insulation R-value,see Page JA4-3 and Equation 4-1. For calculating futred wads use the Mass and %Furring Construction table below. " 1.For Tag/ID indicate the identification name that matches the building plans. 2.Indicate the Assembly Name or type:Roof/Ceiling, Walls,Floors,Slabs, Crawl Space, Doors and etc...lndicate the Frame type and Size:For Wood, Metal, Metal Buildings,Mass, enter 2x4,2x6,or etc...see JA4 for other possible frame type assemblies. 3. Enter the thickness for mass in inches or Spacing between framing members enter; 16"or 24"OC;or Other for all other assembly description such as Concrete Sandwich Panel,Spandrel Panel,Logs,Straw Bale Panel and etc.... 4. Based an the Climate Zone;enter the Standard U factor from Table 151-B, C or D for cad;different assembly Name or type. 5.Enter the Table number that closely resembles the proposed assembly. 6. Enter the R-value that is being installed in the wall cavity or between the framing; otherwise,enter "0". 7. Enter the Continuous Insulation R-value for the proposed assembly;otherwise, enter "0". S.Enter the row and column of the 11-factor value based on Column F Table Number and enter the Assembly Ufactor in Column J 9.The Proposed Assembly LI-factor. Column.1, musi be equal to or less than the Standard U-factor in Column E to comply. Furring Strips Construction Table for Mass Walls Only_ A 1 ]f C D I E F 1 G I 13 1 1 3 x L M Proposed Properties of Masonry and Concrete Added Interior or Exterior Insulation • Walls From Reference in Burring Space from Reference ,joint Appendix Table 4,15.4,3.6.43.7 Joint Appendix Table 4.113 .c a - a. u U tn ,1 u 4-- -- U p 4L C Assembly j o ~ c o y,ti' t° Final Mass Non':or .IA4 Table n ? „ a E R o 't m V 6' o . Assembly Thickness' Type' Number' < s = w t w ti. 5 a'. to a T. W r= U-factor`'' Comment , • ( I I I I I I I - Registration Number: Registration Date/Time: HERS'Provider: 20(18 Residential Compliance Forms August 2009 _Prescriptive Certificate of'Complia. Residential • r CF-1R-ALIT _Residential Alterations (Page 3 of 5) Project Name: Climate Zane# #of Stories Lif Aa/ ROOFING PRODUCTS(COOL ROOFS)§151(1)12 When the area of exterior roof.surface to be replaced exceeds more than 50%of the existing roof area,or more than 1,000 fr', whichever is less, the new roofing area must meet the roofing product"Cool Roof'requirements of§152(b)IHi, 152(b)1Hii,or 152(b)IHiii. Check applicable alternative or exception below if the roof alteration is exempt from the roofing product "Cool Roof"requirements.Note:If any one of the alternatives or exception below is checked, the Aged Solar Reflectance and Thermal Emittance requirements for roofing products in §118(i)are not applicable.Do not fill table below ❑Cool Roofs Not Required in Climate Zones 1-12, 14,and 16 with a Low Sloped. Less or2:12 glilgt1 Roofs Not Required in Climate Zones I through 9 and 16 with a Steep-Sloped Roofs(pitch greater than 2:12)and product unit weight less than 51h/fi2 . Alternatives to§152(h)Illi and§t52(b)Hii,Steep-slope roof(pitch>2:12) ❑ Insulation with a thermal resistance of at least 0.85 hrft2°F/Btu or ai least a 3/4 inch air-space is added to the roof deck over an attic;or ❑ Existing ducts in the attic are insulated and sealed according to§151(f)10;or ❑ In climate zones 10, 12 and 13,with 1 ft.of free ventilation area of attic ventilation for every 150 ft2 of attic floor area,and where at least 30 percent of the free ventilation area is within 2 feel vertical distance of the roof ridge;or ❑ Building has at least R-30 ceiling insulation;or ❑ Building has radiant barrier in the attic meeting the requirements of§151(1)2;or. ❑ Building has no ducts in the attic;or ❑ In climate zones 10, I I, 13 and 14,R-3 or greater roof deck insulation above vented attic. Exception to§152(b)1Hiii,Low-slope roof(pitch S2:12) ❑ Building has no ducts in the attic. Other Exceptions 0 Roofing area covered by building integrated;photovoltaic panels and solar thermal panels are exempt from the below Cool Roof criteria. .O Roof constructions that have thermal mass over the roof membrane with et least 25 lb/ft2 is exempt from the below Cool Roof criteria. - Note:If no CRRC-1 label is available,this compliance method cannot be used,use the Performance Approach to show compliance,otherwise, Check the applicable box below if Exempt from the Roofin Products"Cool Roof"Requirement: Roof Slope Product Weight Product Aged Solar Thermal CRRC Product ID Number' < 2:12 >2:12 < 51b/ft2 >_ 51b/ft2 Types , Reflectance3'4 Emittance SRIs ❑ ❑ ❑ ❑ 04 ❑ 0 0 0 Q^ ❑ ❑ ❑ 0 Qn ❑ ❑ ❑ ❑ ❑4 ❑ ❑ ❑ ❑ 04- I. The CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at www.cootroofs.orp/products/,search.php 2.Indicate the type of product is being used for the roof top,i.e.single-ply roof asphalt roof metal roof etc. 3. If the Aged Reflectance is nor available in.the Cool RoofRating Council's Rated Product Directory then use the Initial Reflectance valuefrom the sante directory and use the equation(0.2+0.7(pariuot—0.2)to obtain a calculated aged value. Where p is the Initial Solar Reflectance. 4.Check box if the Aged Reflectance is a calculated value using the equation above. 5. Calculate the SIU value hr using the SIO- Worksheet al httu://www.energi',ca,gov/title24/and enter the resulting value in the SRI Column above and attach atopy of the SRI- Worksheet to die CF-1R. To apply Liquid Field Applied Coatings,the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage recommended by the coatings manufacturer and meet minimum performance requirements listed in §1180)4. Select the applicable coating: ❑ Aluminum-Pigmented Asphalt Roof Coating ❑ Cement-Based Roof Coating 10 Other • Registration Number: Registration Date/Time: HERS Provider: 2008 Residential Compliance Forms • August 2009 • • , e Prescriptive Certificate of Complirnrce: Residential CF-IR-ALT u Residential Alterations (Page 5 of 5) . . Project Name: I Climate Zone l Ifof Stories • Levi- J HERS VERIFICATION SUMMARY The enforcement agency should pay special attention to the HERS Measures specified in this checklist below. A completed and signed CF-42t Form for all the measures specifier?shall be submitted to the building inspector before fine? inspection. Duct Sealing & Testing HERS verification is requlre.d_for this measure. ❑YES 0 NO YES:In Climate Zones 2 and 9-16,if more than 40 linear feet of new or replacement ducts are installed in unconditioned space,the ducts are to be sealed per§152(b)IDii and the newly installed ducts are to he insulated per §151(1)10. O EXCEPTION:Existing duct systems that are extended,which are constructed,insulated or scaled with asbestos. ❑YES 0 NO YES:In Climate Zones 2 and 9-16, if the existing space-conditioning system(HVAC equipment and ducting)is replaced,the ducts are to be sealed per§152(b)IDi. ❑YES ❑ NO YES:In Climate Zones 2 and 9-16,if the existing HVAC equipment is replaced(including the replacement of the air handler, • outdoor condensing unit of a split system,cooling or heating coil,or the furnace heat exchanger)the ducts are to be sealed per§152(6)1E. O EXCEPTION:Duct systems that are documented to have been previously sealed confirmed through HERS • verification in accordance with procedures in the Reference Residential Appendix 1tA3. • • • ❑ EXCEPTION:Duct systems with less than 40 linear feet in unconditioned space. O EXCEPTION: Existing duct systems constructed,insulated or sealed with asbestos. Refrigerant Charge- Split System HERS verification is required for this measure. ❑YES 0 NO YES:In Climate Zones 2 and 8-15,when the existing HVAC equipment is replaced(including the replacement of the air handler,outdoor condensing unit of a split system A/C or heat pump,cooling or heating coil,or the furnace heat exchanger)a refrigerant charge mcasuremenc shall be verified per§152(b)IF. Central Fan Integrated (CFI)Ventilation System and Fan Watt Draw _The ventilation requirements of 150(o)do not manly to existing residential homes. Ducted Split Systems-Air Conditioners and Heat Pumps: Airflow HERS verification is required for this measure, - ❑ YES ❑NO YES:In Climate Zones 10 through 15,when the existing space-conditioning system(1-IVAC equipment and ducting)is replaced.the airflow and fan watt draw shall be verified per§I 52(b))Ci to meet the requirements of&151M713. Documentation Author's Declaration Statement I certiir that this Certificate of Compliance documentation is accurate and complete. Na% ' ,7GSigna 1 /Frrerll „ 5:r____----r-----e-----c____—/- 1 /Comp y: Date: Address: / � 1f Applicable 0 CEA or 0 CEPS �� I�� �G - 21�j (Certification A): City/SmteJZiy- /)i Phoney 7 -1 q i 37 ) �U ✓l sat `/`/l/ LCj �] Responsible'BuildingDesigne s Declaation Statement ', �__ i • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. • 1 certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform to the requirements of Title 24,fans 1 and 6 of the California Code of Regulations. • The building design features identified on this Certificate of Compliance are consistent with the information provided to document this building design on the other applicable complimree lbnnc, worksheets,calculations,plans mid specification::submitted to the enforcement agency for approval with this building permit application. Name: Signature: Company: Date: Address: ` License: • City/Slate/Zip: I Phone: For ctssistonce or questions regarding the Energy Standards, contact the Energr Hotline at: J-8 WI-772-3300. Itegis;ration h4onbcr Regisnotion bale/Time: HERS Provider: 2(10(.Residential Compliance Forms August 2009 CITY OF COSTA MESA SERVICE REQUEST & PUBLIC ASSISTANCE FORM Date ---- 6 1r / i# ,.. Time / `ca Caller's Name Address / 6 2 7 Phone Nature of Request: (locatioki, type, severity) o; i / se/ =i / p i - / / i ` Referred to c_22`eC Call backEll Service Only n jze Information Only nPerson Receiving Call Por OWNER COMESA, INC. - DATE 5-111-59 JOB ADDRESS 1627 Corsica Place BUILDING PEERMIT NO. 9301 GENERAL CONTRACTOR Dike & Colegrove VALUE $1475,52'00' AP. No. LOT 62 TRACT 2822 FIRE ZONE DESCRIPTION OF woRKRes. w/att. .Garage INSPECTIONS t;2e-tc, DATE GROUP TYPE ZONE Underground Soil 44,4.S U.G. Water/141.5 4--2-2-3-1. PERMITS ISSUED SUBCONTRACTOR Underground Gas DATE NUMBER /, Overhead Water and Gas UI` Rough Heating /Y/f3 7-r� S / ?I/F neve-/'fes /� - !-_,1-7 / 9-'s SAA Rough Plumbing ,fc 7-G'5 ,✓2/&F/ w7 J-/sems--7 /'7,2 Oat Miscellaneous a Prop. SwL-bine Housean. St. Swr. 7 jy,,/ -t L>J�"-tom_,_ Cp,„ r 5/"r,-II l-<r t .}-or y4/ , Sprinkling System _ Heating, Final /J9 PlaY4/ • Plumbing Fixtures A41-S 3-1/✓5r? Final Gas Test is Mi-c-P'-2/-49 Construction Pole Underground Power Rough Wiring /!f 7,-_ G�.r,-., ez.(2,...7-,—, -->.,_ rF 5f,25/ Trenches Forms Steel 3 ' u/ , f / Floor System Steel Reinforce Chimney Re-Rod Bond Beam Sheathing Frame and Flashing k{- %/(Y/)Y Lathing, In Out 'r)'' Plaster, brown coat j8`,11- if-4-51 Plumbing Fixtures, Final MILS R'-2/•-4-0 Electric Fixtures, Final q-,7-.0y Building, Final OCCUPANCY e r�/' 3 J1 Form 210-3M-4.59 9301 . : aa RECEIVED 'e'^d MAY 18 1959 COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P.O.BOX 317 COSTA MESA, CALIFORNIA CITY OF COSTA MESA FOR APPLICANT TO FILL IN COMPLETELY APPLICATION FOR PERMIT TYPE OR PRINT BUILDING • AD BUDRESSILDING 1627 Corsica Place COSTA MESA, CALIFORNIA fOR OFFICE USE ONLY RECEIPT NO. I � (AO/NO. OWNER Comesa, Inc. 3 MAIL R BY DATE RECEIVED DATE ISSUED ADDRESS 419 E. 17th St. jEIVE� ,fi/3- 5--/V-- Costa B DING v CITY Costa Mesa NO. rT81.159 ADDRESS ARCHITECT Carlson& LIC. COSTA MESA, CALIFORNIA OR ENGINEER No. Middlebrook FIRE ADDRESS Garden Garden Grove ZONE CONTRACTOR LIC.Colegrove,Inc. STATELIC.NO. 167293 APPROVED By 4 ; DATE/-5/ 7"7,.,* ADDRESS µy9 E. 17th St. , Costa MA9A ZONING LEGAL I LOT /_rJ I I g 'J ZON NO. S 'I USE OFDI NEW n DESCRIPTION NO. OG BLOCK 7 A q / IPLAN8 )(-BUILDING o f A.P.NO. APPROVED ///"'III r BY t`/ r .t'— DATE / J3 / Mar 60 x 104 (NO.OF BLOCS. YARDS / J/ES / NOW ON LOT none REQUIRED ALLOWED USE OF (CENTER LINE ST.) EXISTING BLDG. none FRONT � FT. IN. SETBACK LINE FROM CENTER OF STREET 551 REAR YARD 25' R.SIDE CSFT. IN. SIDE YARD (LEFT 51 • (RIGHT 51 L.SIDE ` Ff'. . IN. DESCRIPTION OF WORK REAR g9..S—FT. IN. NEW I x0 ALTERATION I II ADDITION I ' REPAIR I II MOVING I I DEMOLISH I SIZEBUILNO.OF DING 1450 ROOMS 6 STORIES 1 EXTERIOR WALL Stucco I ROOF Shingle COVERING COVERING USE OF BUILDING AND WORK TO BE PERFORMED Single Family dwelling with attached double garage . Plan 140BR I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. BUILDING CONSTRUCTION. VALUATION ��—///��� SIGNATURE OFC A/ • PERMIT FEE $ 3L.00 PERM ITTEE PLAN CHECK $ 17.00 $ 14,552. AUTHORIZED AGENYJ�11 JCe & Colegrove, Inc. ]�/yO TOTAL FEE S 5'`+"'